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GLOSSARY

Material contribution definition

Published by a LexisNexis PI & Clinical Negligence expert

What does Material contribution mean?

For material contribution to be proved, the breach need not be the sole, or even principal, cause of the damage, although it must have materially contributed to it.

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Delay in medical treatment

Delay in medical treatment Introduction The standard of duty of care for doctors and other medical practitioners is well-known. However, claims for delayed treatment and diagnosis are invariably complicated by causation issues. Almost all clinical negligence claimants will (obviously) come to their clinician with risks to their health already in place. Establishing whether, and precisely what, additional loss and damage has been caused by the alleged medical negligence is the issue at the heart of this area of practice. Types of claim Delayed treatment and diagnosis cases are common in all parts of the NHS. The most significant claims arise in cases of acute and emergency care—there are so many stages in the journey of a sick patient through a complex major hospital, and the opportunities for delay present themselves at each stage. Key examples might be: • delays with ambulances arriving at the scene or transporting to hospital • patients being wrongly triaged at A&E • delays in being referred for investigations • investigations being incorrectly interpreted...

Clinical negligence claims involving labour and delivery—injuries to the child

Clinical negligence claims involving labour and delivery—injuries to the child This Practice Note sets out practical considerations when managing these types of claims, followed by an overview of common types of injury to children occurring during childbirth. It focuses on liability rather than quantum. The usual requirements regarding breach of duty, causation and damages apply. See: • Clinical negligence liability—overview • Clinical negligence damages—overview • Catastrophic claims—overview Informed consent—Montgomery When dealing with birth injury claims you should be familiar with Montgomery which involved a child born with cerebral palsy due to oxygen deprivation during a prolonged labour. The liability issues revolved around the information given to the mother about the mode of delivery and its risks. It has wide-reaching application and has reframed the test for what information should be provided during the consent process. For further guidance on this case and subsequent developments, see Practice Note: Consent in clinical negligence claims—treatment and causation. In CNZ v Royal United Bath Hospitals NHS Foundation Trust...

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Do you have any case law relating to secondary victim claims whereby the psychological injury was suffered as a result of the loss of children?

Do you have any case law relating to secondary victim claims whereby the psychological injury was suffered as a result of the loss of children? Secondary victims A secondary victim is one who suffers psychiatric injury not by being directly involved in the incident but by witnessing it and either: • seeing injury being sustained by a primary victim, or • fearing injury to a primary victim For further guidance, see Practice Note: Psychiatric injury—secondary victims. Case law McLoughlin v O'Brian In this case the claimant’s husband and three children were involved in a road accident caused by the negligence of the defendants. One of the claimant’s children was killed and its husband and other two children were severely injured. At the time of the accident the claimant was at home two miles away. The claimant claimed damages against the defendants for the nervous shock, distress and injury to its health caused by the defendants' negligence. The House of Lords held that the test of liability...

When dealing with consent issues post-Montgomery, are the characteristics of the patient taken into account? For example, if the patient is a doctor (albeit in a different specialism), could he/she be found to have knowledge of the risks over and above what the treating practitioner may have warned of?

When dealing with consent issues post-Montgomery, are the characteristics of the patient taken into account? For example, if the patient is a doctor (albeit in a different specialism), could he/she be found to have knowledge of the risks over and above what the treating practitioner may have warned of? In Montgomery v Lanarkshire Health Board, the Supreme Court clarified that the adequacy of a medical professional’s disclosure of risk to the patient should not be judged ‘in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art’ (the ‘Bolam’ test). Instead, the test should be patient-centred and should have regard to the risk that a reasonable patient, and one in the particular circumstances of the patient in question, would be likely to attach significance to, and so ought to know about, before being able to give informed consent. The ‘reasonable’ patient is an objective test, whereas the ‘particular circumstances of the patient’ will be subjective and highly fact-specific to each...

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PI & Clinical Negligence weekly highlights—8 May 2025

This week’s edition of PI & Clinical Negligence weekly highlights includes a Court of Appeal decision which confirms the primacy of the ‘but-for’ test of causation. We also consider upcoming changes to whiplash tariff amounts, a Court of Appeal judgment which provides guidance on causation in low-dose asbestos claims and we take a look at recent developments in military deafness claims including a test case which is due to be heard later this year. In addition, we have our usual round-up of other news, cases and New Law Journal articles of interest and we have included a free webinar.

Material contribution and suicide (Zgonec-Rozej v Dr Pereira)

PI & Clinical Negligence analysis: The case arose out of the tragic suicide of a patient while receiving in-patient psychiatric care. It was argued on behalf of the deceased’s dependents that the defendant psychiatrist’s negligent treatment materially contributed to his death. In dismissing the appeal, the Court of Appeal confirmed the primacy of the ‘but-for’ test of causation. The doctrine of material contribution is of limited applicability, arising only where the court is unable to determine causation on a ‘but-for’ basis. This is an important reminder to claimants who seek to rely on material contribution in cases where medical science is sufficiently well-developed to address causation in the usual manner. The case also gave rise to an interesting point on the strategic risks of settling against some but not all defendants prior to trial. Written by Martin Porter KC and Paige Mason-Thom, barristers at 2 Temple Gardens.

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